Blog Watch

Premiums, Politics and Posturing

Kate Steadman, KHN

December 1st, 2009

Despite Director Douglas Elmendorf warning that his agency’s new report “cannot be readily summarized in one or two numbers,” bloggers jumped on the new CBO analysis of  the Senate health bill’s effects on health insurance premiums. They all offered their own take while pointing out how others will misuse the numbers.  And this was in the midst of the sniping in the Senate as debate began.

TPMDC’s Brian Beutler says there are “two separate findings, but it seems likely that Republicans will use the former finding [on the increase in individual market premiums] to attack reform, claiming it will raise people’s premiums, and leave people confused about the second finding, which is actually the one that impacts people’s pocket books.”

But Heritage’s Rea Hederman thinks the large group numbers are bad news as well: “On average, those in large-group employer-sponsored plans would see their premiums remain flat. But this is an average of two subgroups that hides major losses by millions of Americans: 1) employees with generous coverage would see benefits cut due to the tax on high-value plans, and 2) employees with pared-down plans would see their premiums increase due to increased coverage mandates and taxes on medical devices and insurers that would be passed on to employees.”

James Capretta of the New Atlantis thinks CBO’s “terribly optimistic”: “For weeks, experts have been warning that the Senate legislation would lead to serious “adverse selection” in the individual and small-group insurance markets. Adverse selection occurs when, on average, the pool of insured lives becomes less healthy over time compared to a relevant comparison group,” and advises: “At a minimum, before any votes are cast, CBO should make it clear how sensitive their premium estimates are to their assumptions about the risk pool. That way Senators could decide for themselves what to believe.”

Ezra Klein breaks down the numbers and comes up with a  very different conclusion: “So in the final analysis, the effect of reform on your typical individual market purchasers is to give them insurance that’s about 30 percent better but only 10 to 12 percent more expensive, and then assure them subsidies that will lower their payments by more than 50 percent. And if you’re in the small group or large group markets, your premiums are expected to fall a bit. Good deal, no?”

Wonk Room’s Igor Volsky says the piece “underminds arguments against health reform,” and makes a table comparing premium prices before and after the bill.

Bob Laszewski thinks lawmakers should be paying attention to another question: “what is likely to happen to health insurance rates in 2010, 2011, 2012, and 2013 before any of the bill’s benefits occur for both the insurance markets and consumers?”

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